New Medicare Card Transition Ends Next Week: Claim Reject Codes Beginning January 1

CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) Special Edition – Monday, December 23, 2019

New Medicare Card Transition Ends Next Week: Claim Reject Codes Beginning January 1 Get paid. Use Medicare Beneficiary Identifiers (MBIs) now. If you do not use MBIs on claims (with a few exceptions) after January 1, regardless of the date of service, you will get: Electronic claims reject codes: Claims Status Category Code of A7 (acknowledgment rejected for invalid information), a Claims Status Code of 164 (entity’s contract/member number), and an Entity Code of IL (subscriber) Paper claims notices: Claim Adjustment Reason Code (CARC) 16 “Claim/service lacks information or has submission/billing error(s)” and Remittance Advice Remark Code (RARC) N382 “Missing/incomplete/invalid patient identifier” How can you get the MBI? If your patients do not bring their Medicare cards with them: Give them the Get Your New Medicare Card flyer in Englishor Spanish. Use your Medicare Administrative Contractor’s look-up tool. Sign up for the Portal to use the tool. Check the remittance advice. Until December 31, we return the MBI on the remittance advice for every claim with a valid and active Health Insurance Claim Number (HICN). See the MLN Matters Article to learn how to get and use MBIs. Like our newsletter? Have suggestions? Please let us know! The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health and Human Services (HHS).